000165886 001__ 165886 000165886 005__ 20260115140311.0 000165886 0247_ $$2doi$$a10.1111/aos.14905 000165886 0248_ $$2sideral$$a147427 000165886 037__ $$aART-2021-147427 000165886 041__ $$aeng 000165886 100__ $$aLlorente-González, Sara 000165886 245__ $$aThe role of retinal fluid location in atrophy and fibrosis evolution of patients with neovascular age‐related macular degeneration long‐term treated in real world 000165886 260__ $$c2021 000165886 5060_ $$aAccess copy available to the general public$$fUnrestricted 000165886 5203_ $$aAbstractPurposeTo assess the effect of clinical factors on the development and progression of atrophy and fibrosis in patients with neovascular age‐related macular degeneration (nAMD) receiving long‐term treatment in the real world.MethodsAn ambispective 36‐month multicentre study, involving 359 nAMD patients from 17 Spanish hospitals treated according to the Spanish Vitreoretinal Society guidelines, was designed. The influence of demographic and clinical factors, including the presence and location of retinal fluid, on best‐corrected visual acuity (BCVA) and progression to atrophy and/or fibrosis were analysed.ResultsAfter 36 months of follow‐up and an average of 13.8 anti‐VEGF intravitreal injections, the average BCVA gain was +1.5 letters, and atrophy and/or fibrosis were present in 54.8% of nAMD patients (OR = 8.54, 95% CI = 5.85–12.47, compared to baseline). Atrophy was associated with basal intraretinal fluid (IRF) (OR = 1.87, 95% CI = 1.09–3.20), whereas basal subretinal fluid (SRF) was associated with a lower rate of atrophy (OR = 0.40, 95% CI = 0.23–0.71) and its progression (OR = 0.44, 95% CI = 0.26–0.75), leading to a slow progression rate (OR = 0.34, 95% CI = 0.14–0.83). Fibrosis development and progression were related to IRF at any visit (p < 0.001). In contrast, 36‐month SRF was related to a lower rate of fibrosis (OR = 0.49, 95% CI = 0.29–0.81) and its progression (OR = 0.50, 95% CI = 0.31–0.81).ConclusionAtrophy and/or fibrosis were present in 1 of 2 nAMD patients treated for 3 years. Both, especially fibrosis, lead to vision loss. Subretinal fluid (SRF) was associated with good visual outcomes and lower rates of atrophy and fibrosis, whereas IRF yields worse visual results and a higher risk of atrophy and especially fibrosis in routine clinical practice. 000165886 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII-MINECO/RD16-0008$$9info:eu-repo/grantAgreement/ES/ISCIII/PI15-01374 000165886 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.es 000165886 590__ $$a3.988$$b2021 000165886 591__ $$aOPHTHALMOLOGY$$b18 / 62 = 0.29$$c2021$$dQ2$$eT1 000165886 592__ $$a1.314$$b2021 000165886 593__ $$aOphthalmology$$c2021$$dQ1 000165886 593__ $$aMedicine (miscellaneous)$$c2021$$dQ1 000165886 594__ $$a5.8$$b2021 000165886 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000165886 700__ $$aHernandez, Maria 000165886 700__ $$aGonzález-Zamora, Jorge 000165886 700__ $$aBilbao-Malavé, Valentina 000165886 700__ $$aFernández-Robredo, Patricia 000165886 700__ $$aSaenz-de-Viteri, Manuel 000165886 700__ $$aBarrio-Barrio, Jesús 000165886 700__ $$aRodríguez-Cid, María José 000165886 700__ $$aDonate, Juan 000165886 700__ $$aAscaso, Francisco J. 000165886 700__ $$aGómez-Ramírez, Ana M. 000165886 700__ $$aAraiz, Javier 000165886 700__ $$aArmadá, Félix 000165886 700__ $$0(orcid)0000-0001-6664-6275$$aRuiz-Moreno, Óscar$$uUniversidad de Zaragoza 000165886 700__ $$aRecalde, Sergio 000165886 700__ $$aGarcía-Layana, Alfredo 000165886 700__ $$a 000165886 7102_ $$11013$$2646$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Oftalmología 000165886 773__ $$g100, 2 (2021), e521-e531$$pActa ophthamol.$$tACTA OPHTHALMOLOGICA$$x1755-375X 000165886 8564_ $$s1167294$$uhttps://zaguan.unizar.es/record/165886/files/texto_completo.pdf$$yVersión publicada 000165886 8564_ $$s2576184$$uhttps://zaguan.unizar.es/record/165886/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000165886 909CO $$ooai:zaguan.unizar.es:165886$$particulos$$pdriver 000165886 951__ $$a2026-01-15-12:37:19 000165886 980__ $$aARTICLE